Titania Veda
Twelve Hours in 118 Time
7:30 a.m.
Even in the early hours of the morning, the parking lot of Cipto Manungkusumo Hospital, or RSCM, in Central Jakarta is filling up fast.
Five ambulances are parked in front of the children’s wing. “Ambulans Darurat,” or Emergency Ambulance, has been stenciled boldly in red on the front of the forest-green vehicles.
A man with plump cheeks and a short, squared-off beard is inside one of them, checking an oxygen tank.
“We have to go to Manggarai [South Jakarta] to fill up our oxygen tanks,” Dany Widyanto says.
At 26, he’s been a paramedic for four years. An older man with a perpetual smile, dressed in the regulation blue Ambulans 118 uniform and scruffy sneakers, introduces himself as Habibi Dukhri.
“We always travel in teams of two. Dany and I take turns driving,” Habibi says.
Today the two have been paired up for their 12-hour shift, covering Central Jakarta.
8:00 a.m.
At the oxygen-filling station, Dany and Habibi run into Marlinawati Susana and Mutmainah. Known around RSCM as Marlina and Imut, the two women are also attending to their tanks before their shift begins.
“We have to check our equipment every morning because patients are more likely to die from lack of oxygen than delays in [getting to the hospital] caused by traffic jams,” Marlina says, referring to the maddening traffic conditions in the Indonesian capital.
Slender and long-limbed, she has pulled her hair back into a ponytail, accentuating her pale, heavily powdered skin.
Her partner, Imut, wears a jilbab, or headscarf, and no makeup. She lets Marlina do most of the talking.
They have both been with the ambulance unit for more than two years.
“Almost half of our crew are women. There is no difference between us [men and women],” Habibi says.
Marlina says, “People work here because they like a challenge.”
The four of them say their goodbyes and hop back into their ambulances.
8:20 a.m.
Habibi and Dany leave the oxygen station for the Hotel Indonesia traffic circle in Central Jakarta, where they are expected to “stand by” from 8 a.m. to 10 a.m.
They are not worried about being late; it is likely they will just be sitting there, waiting.
“In the beginning, I liked the idea of going all around the city,” Habibi says. “And after doing it for a while, I began to really enjoy it. In the hospital, there is a senior-junior system. Here, [as paramedics] we are all equals.”
In the five years that Habibi has been a paramedic, not a single patient has died in his ambulance.
“Victims sometimes die when we arrive late on the scene, but never in the ambulance because we always stabilize them before moving them,” Habibi says.
Even in heavy traffic jams?
“The response time for road accidents is often longer due to traffic. Sometimes when we get there, the victim has already been taken away in a bajaj [auto-rickshaw] or taxi,” Habibi says. “We often lose victims that way.”
Ambulance 118 is a national government ambulance service. The service is free for people with welfare cards, as well as road accident victims. For house calls and hospital-to-hospital transfers, there is a flat-rate charge of Rp 200,000 ($17), regardless of mileage. The cost includes all necessary services and supplies.
“People don’t know much about us,” Habibi says. “Sometimes, when there is a road accident, say someone on a bike, they often refuse our help because they think they have to pay.”
Dany is broody and seemingly fed up. But he concedes, with a roguish gleam in his eyes, that he is in his element when on the graveyard shift: from 7:30 p.m. to 7:30 a.m.
“The most exciting are the nightclub victims,” he says. “You never know what is going to happen! Someone might be drunk and try to pick a fight with us.
“That is a cause of distress for paramedics because our safety is important. If it is not safe for us, it is better we refrain from treating the victims until backup from police or another unit arrives. Don’t try to be a hero.”
8:40 a.m.
At the traffic circle in Central Jakarta, Habibi relaxes in the back of a police pick-up truck fitted with benches and a canvas roof. He has found a friend: a policeman directing the rush-hour traffic.
“We like to call ourselves street children,” Habibi says with a laugh.
9:58 a.m.
Habibi takes a call and the men get into the ambulance.
“We’re off to the north now. They are out of ambulances in Kelapa Gading because most are them are being used to take welfare card holders to the hospital,” he says. RSCM has only five operational ambulances.
“Before, when we had 15 ambulances, our response time was excellent. At times, three ambulances would converge in one place,” he says. “We aim for good response time.”
Dany sounds the siren and the ambulance sails through a red light. Drivers honk their horns in protest. They still do not know the nature of the emergency.
“We often get crank calls, so our operator will take a call, write down the information, and call the person back at their number,” Habibi explains.
The ambulance veers into the busway lane, which is lawful in an emergency. “Ambulances have priority on the road but people still don’t realize it,” Habibi says.
He rings the operator for the exact location, then reports to Habibi: “We’re standing down. There is another ambulance closer.” They turn back to Menteng, Central Jakarta.
10:45 a.m.
Habibi pulls into a small police post at Suropati Park, Menteng, to use the bathroom. Dany perches himself on a steel bench. His partner returns with milky coffee. “I smoke sometimes. In the field, we can survive all day on just coffee and cigarettes,” Dany says.
“They call us ambulans gaul [cool ambulance drivers] because we are all so young,” he laughs.
11:00 a.m.
Habibi’s phone rings. “Here we go,” he says. “Standby for a protest? MPR/DPR? Inside or outside the building?” he asks the operator, referring to the People’s Consultative Assembly and the House of Representatives buildings.
“Two units have been called to be on standby for this protest,” he tells Dany. They get in the ambulance and Habibi starts reading his newspaper.
11:20 a.m.
Dany parks in the street outside the legislative complex and walks over to meet Suyitno and Eka, from the Ambulance 118 unit in from Tanjung Duren, West Jakarta.
“The protest has not even started,” Suyitno reports.
11:30 a.m.
A man in uniform approaches the ambulance. A young woman wearing a pink T-shirt is slumped in his arms, her long hair covering her face.
A crowd forms. Within seconds the woman is being given oxygen through a nasal cannula.
“Wake up, Mega,” Dany says, once he has discovered the victim’s name.
Habibi pops around the door with an oxygen mask. “Dany, use this instead.”
Habibi and his colleagues chat with the victim’s father, seemingly unperturbed by the situation. Her husband appears with a plastic cup of tea.
The woman stirs, managing to raise her head just enough to sip the sweet tea.
“How is she?” Suyitno inquires. “Stable,” comes the reply from inside the ambulance.
The woman had followed her father to Jakarta from Ngawi, East Java Province, to support him in his protest to increase the tenure of village administrative leaders.
Although Habibi advises the patient to rest, the husband calls a taxi and they leave.
12:05 p.m.
A man approaches Eka and asks her to check his blood pressure, which she does. It is not long before a Civilian Protection Service officer enters the ambulance. “What is your complaint, sir?” He too is worried about low-blood pressure. Then comes an elderly gentleman with a black cap.
“I have a headache,” he says to Eka, as she dutifully pumps the blood pressure meter.
Habibi makes small talk with the men about the protest.
“If one comes in, the rest follow. They are often looking for headache meds,” explains Habibi, as Suyitno informs the growing crowd of the same thing.
“We don’t supply oral meds,” he tells the people lining up. “We only carry them for emergencies and evacuations.”
Three more men ask Habibi to check their blood pressure. “They will all line up because they think we are offering freebies,” Suyitno says.
“My chest hurts,” one man says.
12:50 p.m.
Eka wants to pray at her post in Tanjung Duren, West Jakarta. Everyone heads there for lunch.
1:00 p.m.
Habibi heads to the upper level of the Tanjung Duren Fire Station with Dany. They meet up with Purwiyanto, the area coordinator for West Jakarta. “We don’t have a post of our own, so we are sharing with the fire department,” Purwiyanto says, as the two paramedics settle on the floor.
Habibi rings headquarters to report on his whereabouts. On TV, actor Gading Marten is trying to find lines on a show called “Missing Lyrics.” Looking on, the paramedics dig into their meals.
2:40 p.m.
“We are picking up a patient from Pelni hospital and bringing him home. We do not know the condition of the patient yet,” Habibi says as they leave the fire department.
Turning onto Jalan S. Parman, they are faced with a traffic jam. “This is Jakarta,” comments Habibi as Dany switches on the siren. Dany looks agitated. “I don’t like jams,” he says. Habibi falls asleep.
3:05 p.m.
“Don’t take a ticket,” Habibi tells Dany as they enter Pelni Hospital in Central Jakarta. Once stationed in front of the emergency doors, Habibi sets up the gurney. Dany rolls it in.
“Straight ahead,” instructs the hospital staff member. The patient’s family greets them. A relative helps Habibi and Dany with the best way to get back home. “Go past Pondok Kopi because it is not too far. The patient has sores on his back,” she says.
In a darkened room with three beds and green pleated curtains, the patient lies on his back: A frail elderly man, covered only with a blanket, he has had a stroke and been at the hospital a week. A nurse dresses him carefully.
Dany and Habibi have their latex gloves on. “Sir, we are going to lift you up slowly, OK?” Habibi says.
They wrap the patient in blankets and lift him onto the gurney. “Does it hurt?” Dany asks. The patient moans, almost inaudibly.
3:20 p.m.
Everyone piles into the ambulance. The patient’s daughter-in-law sits up front. Habibi is with the patient in back. The patient asks Habibi to pull off his Band-Aid saying it pains him. “It hurts from the injection, Pak. This is to prevent bleeding,” Habibi explains.
He starts making small talk. “How old are you, Pak?” he asks. “72.” He gently holds the old man’s hand and takes his blood pressure. “Slowly, Dany,” he says as the road gets bumpy. The patient’s feet peek out of the blue hospital blankets, crusted with sores and cracked skin.
“Sometimes we travel out of town, like to Solo in Central Java when patients want to spend their last days at home,” Habibi says. “Then we would have a mechanic with us, in case the vehicle breaks down.”
The patient asks Habibi to scratch an itch on his left arm. Up front, Dany is trying to find the exit. “There have been coma patients who go home to die. We have to be there when the families pull the plug,” Habibi says.
4:10 p.m.
The ambulance arrives at the patient’s home in Pulo Gebang, East Jakarta. Three dogs roam around the patio; paw prints pepper the floor. Dany and Habibi roll the gurney into the house. With the help of the patient’s relatives, they lift him onto the bed. “Pak, get better soon,” Habibi says before walking back to the car.
He fills out a form with the patient’s details for the relatives to sign.
4:20 p.m.
Habibi fills out the daily log book and helps Dany with directions back to Central Jakarta. “A GPS system was set up for Jakarta but due to a lack of funds, it was never turned on,” Dany says. “We know our way around Central Jakarta but sometimes we get calls to unfamiliar places and have to ask for directions.”
5:25 p.m.
Back at RSCM, the parking lot is full. Dany manages to find a spot and turns off the engine. Habibi goes to find snacks. “Before we had a post at this hospital, but no more. So we chill in the ambulance,” Dany says.
When Habibi returns with fried snacks, they talk about the rise of new ambulances in Jakarta hospitals.
“What irks me is that some people still think of us as mere drivers. It is to be expected, I guess, with all the fancy new ambulances nowadays being driven by drivers who are not trained paramedics like us,” Habibi says.
“Yet, people only trust us when it comes to big emergencies,” Dany adds. “Because if you compare us with fresh medical grads, they lose out to our experience in the field.”
6:00 pm
Habibi has gone for evening prayers. Two women approach the car.
“Pak, can you take a patient to an old folks’ home on Radio Dalam?” they ask Dany. He asks about the patient’s condition. He is still in the intensive care unit.
Dany calls headquarters to find out if the night-shift paramedics are available.
“Can you not take him yourself?” the woman asks.
“I am sorry, it’s procedure to have two paramedics in the ambulance,” Dany says. “And we recommend moving the patient late at night, when there is less traffic. Tonight, all the patients that have to be transported from RSCM are ‘bad’ ones,” Dany says.
“A ‘bad’ patient does not have all his ABCs [airways, breathing, circulation] in working order. Usually it’s the airway that’s most problematic. Our patient today was a ‘good’ one because he was stable.
“Sometimes hospitals are funny. They call us to take patients away when they are critical or ‘bad’ because they consider it bad luck if they die in the hospital.
It begins to rain. Habibi returns and Asep, the Central Jakarta area coordinator, jumps into the ambulance. “Not going home?” Dany asks him. Asep snorts, “Ha! I am sleeping in the ambulance tonight!”
7:20 p.m.
The rain stops. Habibi and Dany spill out of the ambulance into the wet parking lot and head home.
